Crisis in mental healthcare forces NHS to use costly private hospitals

FOR NEARLY nine months, Bob Thurlow has been 300 miles from home in a pounds 1,000-a-week private psychiatric hospital, where his doctors say he receives minimal treatment that does nothing to speed his recovery.

Mr Thurlow, 31, who is a trained chef, wants to go home. His psychiatrists say his condition would be improved by being moved to an open NHS hospital nearer to his family. They also believe he is not a danger to himself or to anyone else.

Mr Thurlow is one of up to 400 NHS psychiatric patients currently staying in private hospitals and costing taxpayers millions of pounds because of a crisis in mental healthcare. Some have spent more than four years in private hospitals in an environment that NHS psychiatrists say does not promote speedy recovery.

Up to 68,171 NHS beds have been lost since 1987 following the closure of the big 'asylums' and the move to community care. During the same period, there has been a 5 per cent increase in private sector psychiatric beds.

NHS psychiatrists are worried that caring for patients in the private sector and many miles from home fragments integrated care, delays return to the community and can lead to relapse. One psychiatrist said: 'Patients are backing up like jumbo jets circling an airport. This does nothing for the good of patients. It creates stress and anxiety.'

Bob Thurlow was moved 300 miles away from his parents, who live in Gravesend, Kent, to Stockton Hall, a private hospital at Skipton near York, last November. Since then he has shared a 24-bed ward with NHS patients from Stirling in Scotland, the Edith Morgan centre in Torquay, Newham in London, and Sussex.

Mr Thurlow was diagnosed schizophrenic four years ago. He is a Section 37 patient who can be moved only at the discretion of the Home Secretary. Two requests for transfer have already been turned down.

'Staffing here on a ward for 24 patients is the same as on an NHS ward for 12,' he said. 'It's healthcare on the cheap in terms of staffing, but it will cost something to keep me here all year.

'Most of the day we just vegetate, looking at each other or out of the window. The day is filled with things designed to waste our time and not really help our conditions. I have two 15-minute periods of parole in the grounds per day.'

While Mr Thurlow recognises that he must remain on medication to control his schizophrenia which resulted in his arrest for arson, he is worried that he could become institutionalised.

He is also concerned that he rarely sees his family - he has been home only twice since arriving in November.

Dr James MacKeith of the Royal Bethlem Hospital in south London, and chairman of the Royal College of Psychiatrists' forensic section, said: 'To treat people miles from home is bad in principle. There is the problem that the location and the function of these hospitals means that there is no link with the NHS psychiatric unit the patient has been sent from.

'Even if the private sector were super-efficient, there must be some profit built into the price and that margin must affect care.'

Mr Thurlow was sent to Stockton Hall after being arrested in Hackney, east London, and is one of 55 Hackney patients who have been found beds in hospitals across the country because the regional secure unit is full. The local psychiatric hospital, Hackney Hospital, has been condemned by the Mental Health Commission as 'not a fit place for the care of detained patients'.

Last year, City and East London Health Authority, which covers Hackney, spent pounds 1.18m on mental health services including private long-stay and medium-secure units. This year they predict an overspend of pounds 800,000 on top of this.

Dr Trevor Turner, a consultant psychiatrist who works at St Bartholomew's Hospital in the City of London and the Homerton Hospital in east London, and has treated Mr Thurlow, said he was unhappy that patients were sent so far away but he and his colleagues were forced to use the private sector because there were no other beds available.

'We never quite know how many people are in private hospitals from day to day,' he said. He believes it does nothing to help patients. 'It creates stress and anxiety having to travel and more problems for staff. It is certainly not fair on relatives.'

Stockton Hall is managed by Partnerships in Care, part of the General Healthcare Group which runs six hospitals throughout the country with, currently, 340 NHS patients. The managing director, Peter Farrier, said hospital standards were the same as the NHS.

'The staffing levels are set by the NHS. In fact, adding up all the psychiatrists, occupational therapists and psychologists available, I would think we provide better levels than some NHS facilities.'